特发性右室流出道室速的昼夜发作规律及临床意义

目的：探讨特发性右室流出道室速的昼夜发作规律及临床意义，方法：对12例特发性右室流出道室速患者在基础状态进行动态心电图（Holter)监测，分别记录24h中每小时内心律失常发作频数及平均心率，了解室速，室早发作的昼夜规律，结果：基础状态下，室速，连发室早，平均心率在24h内呈不均一分布（P＜0．001），其发作规律呈白天多，夜间少，单个室呈不均一分布，但整个差异无显著性，平均心率与室速，连发室早互正相关，单个室早与平均心率无相关性，结论：左室流出道室速患者24h内室速，连发病早呈明显的昼夜节律变化，提示特发性右室流出道室速的发生与交感迷走神经平衡失调有关。

Circadian Variation of Idiopathic Ventricular Tachycardia Originating from Right Ventricular Outflow Tract and Its Clinical Implications

Objective:To determine the circadian variation and its clinical implications of ventricular arrhythmais in the patients with idiopathic ventricular tachycardia originating from right ventricular outflow tract (IRVOT-VT). Methods:Twelve patients with sustained and/or nonsustained IRVOT-VT were studied. A two channels 24 h ambulatory Holter electrocardiographic recording was obtained from each patient in basic condition. Results:Hourly frequency of VT, coupling premature ventricular contractions (PVCs) and mean heart rate did not show uniform distribution, The high attack was in the day and the low at night in basic condition. The distribution of single PVCs showed no significant difference during 24 hours. The VT, coupling PVCs were positively correlated with mean heart rate. However, single PVCs did not correlated with mean heart rate. Conclusion:The initiation of VT and (or) coupling VPCs exhibted significant circadian variation, and these results suggested that sympathovagal balance dysfunction was related to the initiation of IRVOT-VT.